[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 2425 Introduced in Senate (IS)]

113th CONGRESS
  2d Session
                                S. 2425

   To require the Secretary of Veterans Affairs to carry out a pilot 
program to reduce the shortage of psychiatrists in the Veterans Health 
Administration of the Department of Veterans Affairs by repaying loans 
  for certain psychiatrists, to carry out a pilot program to provide 
  housing allowances to health care providers of the Veterans Health 
Administration who accept assignment at rural and highly rural clinics, 
                        and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              June 4, 2014

 Mr. Begich (for himself and Mr. Pryor) introduced the following bill; 
which was read twice and referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
   To require the Secretary of Veterans Affairs to carry out a pilot 
program to reduce the shortage of psychiatrists in the Veterans Health 
Administration of the Department of Veterans Affairs by repaying loans 
  for certain psychiatrists, to carry out a pilot program to provide 
  housing allowances to health care providers of the Veterans Health 
Administration who accept assignment at rural and highly rural clinics, 
                        and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ensuring Veterans' Resiliency Act''.

SEC. 2. PILOT PROGRAM ON REPAYMENT OF EDUCATIONAL LOANS FOR CERTAIN 
              PSYCHIATRISTS OF VETERANS HEALTH ADMINISTRATION.

    (a) In General.--The Secretary of Veterans Affairs shall carry out 
a pilot program to repay loans of individuals described in subsection 
(b) that--
            (1) were used by such individuals to finance the 
        educational expenses of such individuals relating to 
        psychiatric medicine, including education leading to--
                    (A) an undergraduate degree;
                    (B) a degree of doctor of medicine; or
                    (C) a degree of doctor of osteopathy; and
            (2) were obtained from any of the following:
                    (A) A governmental entity.
                    (B) A private financial institution.
                    (C) An institution of higher education.
                    (D) Any other entity as specified the Secretary for 
                purposes of the pilot program.
    (b) Eligible Individuals.--
            (1) In general.--Subject to paragraph (2), an individual 
        eligible for participation in the pilot program is an 
        individual who--
                    (A) either--
                            (i) is licensed or eligible for licensure 
                        to practice psychiatric medicine in the 
                        Veterans Health Administration of the 
                        Department of Veterans Affairs; or
                            (ii) is enrolled in the final year of a 
                        residency program leading to a specialty 
                        qualification in psychiatric medicine that is 
                        approved by the Accreditation Council for 
                        Graduate Medical Education; and
                    (B) demonstrates a commitment to a long-term career 
                as a psychiatrist in the Veterans Health 
                Administration, as determined by the Secretary.
            (2) Prohibition on simultaneous eligibility.--An individual 
        who is participating in any other program of the Federal 
        Government that repays the educational loans of the individual 
        is not eligible to participate in the pilot program.
    (c) Selection.--
            (1) In general.--The Secretary shall select not less than 
        10 individuals described in subsection (b) to participate in 
        the pilot program for each year in which the Secretary carries 
        out the pilot program.
            (2) Rural or highly rural areas.--Of the individuals 
        selected under paragraph (1), not less than five shall be 
        individuals who practice psychiatric medicine in a rural area 
        or highly rural area or demonstrate a commitment to practice 
        psychiatric medicine in such an area.
    (d) Period of Obligated Service.--The Secretary shall enter into an 
agreement with each individual selected under subsection (c) in which 
such individual agrees to serve a period of obligated service for the 
Veterans Health Administration in the field of psychiatric medicine, as 
determined by the Secretary for purposes of the pilot program, in 
exchange for the repayment of the loan or loans of such individual 
under the pilot program.
    (e) Loan Repayments.--
            (1) In general.--Subject to paragraph (2), a loan repayment 
        under this section may consist of payment of the principal, 
        interest, and related expenses of a loan obtained by an 
        individual who is participating in the pilot program for all 
        educational expenses (including tuition, fees, books, and 
        laboratory expenses) of such individual relating to education 
        described in subsection (a)(1).
            (2) Limit.--The amount paid by the Secretary under the 
        pilot program for each year of obligated service agreed to by 
        an individual under subsection (d) may not exceed $60,000.
    (f) Breach.--
            (1) Liability.--An individual who participates in the pilot 
        program and fails to satisfy the period of obligated service 
        under subsection (d) shall be liable to the United States, in 
        lieu of such obligated service, for the amount that has been 
        paid to or on behalf of the individual under the pilot program, 
        reduced by the proportion that the number of days served for 
        completion of the period of obligated service bears to the 
        total number of days in the period of obligated service of such 
        individual.
            (2) Repayment period.--Any amount of damages that the 
        United States is entitled to recover under this subsection 
        shall be paid to the United States not later than one year 
        after the date of the breach of the agreement.
    (g) Report.--
            (1) In general.--Not later than 90 days after the date on 
        which the pilot program terminates under subsection (i), the 
        Secretary shall submit to the Committee on Veterans' Affairs of 
        the Senate and the Committee on Veterans' Affairs of the House 
        of Representatives a report on the pilot program.
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) An assessment of the overall effect of the 
                pilot program on the psychiatric workforce shortage of 
                the Veterans Health Administration.
                    (B) A current assessment of the long-term stability 
                of the psychiatric workforce of the Veterans Health 
                Administration.
                    (C) Strategies of the Veterans Health 
                Administration to improve and increase the ability of 
                the Administration to promote the physical and mental 
                resiliency of all veterans.
    (h) Regulations.--The Secretary shall prescribe regulations to 
carry out this section, including standards for qualified loans and 
authorized payees and other terms and conditions for the making of loan 
repayments.
    (i) Termination.--The authority to carry out the pilot program 
shall expire on the date that is three years after the date on which 
the Secretary commences the pilot program.

SEC. 3. COMPTROLLER GENERAL OF THE UNITED STATES STUDY ON PAY 
              DISPARITIES OF PSYCHIATRISTS OF VETERANS HEALTH 
              ADMINISTRATION.

    (a) Study.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act, the Comptroller General of the 
        United States shall conduct a study of pay disparities among 
        psychiatrists of the Veterans Health Administration of the 
        Department of Veterans Affairs.
            (2) Elements.--The study conducted under paragraph (1) 
        shall include--
                    (A) an examination of laws, regulations, practices, 
                and policies, including salary flexibilities, that 
                contribute to pay disparities described in paragraph 
                (1); and
                    (B) recommendations with respect to legislative or 
                administrative actions to improve equity in pay among 
                psychiatrists of the Veterans Health Administration.
    (b) Report.--Not later than one year after the date on which the 
Comptroller General completes the study under subsection (a), the 
Comptroller General shall submit to the Committee on Veterans' Affairs 
of the Senate and the Committee on Veterans' Affairs of the House of 
Representatives a report on the results of the study.

SEC. 4. PILOT PROGRAM ON HOUSING ALLOWANCES FOR HEALTH CARE PROVIDERS 
              OF VETERANS HEALTH ADMINISTRATION ACCEPTING ASSIGNMENT AT 
              RURAL AND HIGHLY RURAL COMMUNITY-BASED OUTPATIENT 
              CLINICS.

    (a) Pilot Program Authorized.--The Secretary of Veterans Affairs 
may carry out a pilot program to assess the feasibility and 
advisability of providing a housing allowance to health care providers 
of the Veterans Health Administration of the Department of Veterans 
Affairs who accept assignment at rural or highly rural community-based 
outpatient clinics as a means of encouraging such health care providers 
to accept assignment to such clinics.
    (b) Eligibility.--An individual is eligible for participation in 
the pilot program if the individual--
            (1) is a health care provider;
            (2) is, or agrees to become, an employee of the Veterans 
        Health Administration on a full-time basis in a health care 
        position designated by the Secretary for purposes of the pilot 
        program; and
            (3) accepts an assignment in such position for a term of 
        not less than 36 months at a rural or highly rural community-
        based outpatient clinic selected by the Secretary for purposes 
        of the pilot program.
    (c) Conditions on Payment of Housing Allowance.--Except as provided 
in subsection (d)(3), an individual may be provided a housing allowance 
under the pilot program only while--
            (1) in good standing as a health care provider within the 
        Veterans Health Administration; and
            (2) assigned as a health care provider at a rural or highly 
        rural community-based outpatient clinic.
    (d) Amount of Housing Allowance.--
            (1) Monthly amount during initial term.--During the first 
        36 months of participation in the pilot program, the housing 
        allowance provided a health care provider participating in the 
        pilot program shall be provided on a monthly basis at a rate 
        that is equivalent to the monthly rate of basic allowance for 
        housing (BAH) payable under section 403 of title 37, United 
        States Code, to members of the uniformed services whose grade, 
        dependency status, and geographic location most closely equals, 
        as determined by the Secretary, the grade of such provider 
        under section 7404 of title 38, United States Code, and the 
        dependency status and geographic location of such provider.
            (2) Monthly amount for certain providers for additional 
        term.--If upon completion of the first 36 months in the pilot 
        program a health care provider accepts continuing participation 
        in the pilot program at a rural or highly rural community-based 
        outpatient clinic for a term of not less than 12 additional 
        months, the housing allowance provided the health care provider 
        under the pilot program shall be provided on a monthly basis 
        for such additional months at a rate determined in accordance 
        with paragraph (1).
            (3) Bonus amount.--
                    (A) Completion of initial term.--Any health care 
                provider who successfully completes 36 months of 
                participation in the pilot program shall be paid upon 
                completion of participation in the pilot program an 
                amount equal to three months of the monthly rate of 
                housing allowance provided the health care provider 
                under paragraph (1) during the last month before the 
                provider's completion of participation in the pilot 
                program.
                    (B) Completion of additional one-year term.--Any 
                health care provider who successfully completes 48 
                months of participation in the pilot program shall be 
                paid upon completion of participation in the pilot 
                program an amount equal to 12 months of the monthly 
                rate of housing allowance provided the health care 
                provider under paragraph (2) during the last month 
                before the provider's completion of participation in 
                the pilot program.
                    (C) Completion of additional two-year term.--Any 
                health care provider who successfully completes 60 
                months of participation in the pilot program shall be 
                paid upon completion of participation in the pilot 
                program an amount equal to 13 months of the monthly 
                rate of housing allowance provided the health care 
                provider under paragraph (2) during the last month 
                before the provider's completion of participation in 
                the pilot program.
                    (D) No requirement to remain on assignment.--An 
                amount payable under this paragraph shall be paid 
                whether or not the health care provider concerned 
                remains in an assignment at a rural or highly rural 
                community-based outpatient clinic.
    (e) Supplemental Nature of Allowance.--Any housing allowance 
provided under the pilot program shall be in addition to any pay 
(including basic pay, special pay, and retirement or other bonus pay) 
payable to personnel of the Veterans Health Administration personnel 
under chapter 74 of title 38, United States Code, or any other 
provision of law.
    (f) Annual Reports.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act and not less frequently than once 
        each year thereafter while the pilot program is in effect, the 
        Secretary shall submit to the Committee on Veterans' Affairs of 
        the Senate and the Committee on Veterans' Affairs of the House 
        of Representatives a report on the pilot program.
            (2) Elements.--Each report submitted under paragraph (1) 
        shall include the following:
                    (A) A current description of the pilot program, 
                including the current number of participants in the 
                pilot program and the amounts of housing allowance 
                being provided such participants.
                    (B) A current assessment of the value of the 
                housing allowance under the pilot program in 
                encouraging health care providers in accepting 
                assignment to rural and highly rural community-based 
                outpatient clinics.
    (g) Funding.--Amounts for housing allowances under the pilot 
program shall be derived from amounts available for the Veterans Health 
Administration for Medical Services.
    (h) Sunset.--
            (1) In general.--No individual may commence participation 
        in the pilot program on or after the date that is five years 
        after the date of the enactment of this Act.
            (2) Continuation of on-going provision of allowance.--
        Nothing in paragraph (1) shall be construed to prohibit the 
        Secretary from providing housing allowances under the pilot 
        program to individuals who commence participation in the pilot 
        program before the date that is five years after the date of 
        the enactment of this Act.
    (i) Rural or Highly Rural Community-Based Outpatient Clinic 
Defined.--In this section, the term ``rural or highly rural community-
based outpatient clinic'' means a community-based outpatient clinic of 
the Veterans Health Administration that predominantly serves veterans 
who live in rural areas and highly rural areas.

SEC. 5. DEFINITIONS.

    In this Act:
            (1) Highly rural area.--The term ``highly rural area'' 
        means an area located in a county or similar community that has 
        less than seven individuals residing in that county or 
        community per square mile.
            (2) Rural area.--The term ``rural area'' means an area that 
        is not an urbanized area or a highly rural area.
            (3) Urbanized area.--The term ``urbanized area'' has the 
        meaning given that term by the Director of the Bureau of the 
        Census.
                                 <all>